Costs and Care Benefits in Aetna and Banner Health Collaboration

Aetna August 28, 2014

Aetna and Banner Health Network today announced that their accountable care collaboration resulted in a shared savings of approximately $5 million on Aetna Whole Health fully-insured commercial membership in 2013 and a five percent decline in average medical cost on the members. At the same time, Aetna and BHN improved cancer screening rates, blood sugar management in diabetic members and reduced avoidable hospital admissions. The results demonstrate that patients benefit when physicians and health plans share resources and work together in accountable care models. Further, Aetna and BHN saw savings and improved medical cost trend on additional membership outside the Aetna Whole Health product.

An accountable care collaboration is a group of healthcare providers who assume responsibility for the quality and cost of care for a group of patients. The collaboration between BHN and Aetna gives consumers and employers better healthcare options. Consumers who receive care in this new model save money by using providers in BHN. They also benefit from a more coordinated, personalized experience that is designed to produce better overall health outcomes.

Through care coordination by a clinical team and proactive management of patients’ needs, rather than episode-based treatment of illness, providers in accountable care models can provide more efficient and cost-effective care. Health plans support the practice with relevant patient care data, analysis and quality measurement along with financial rewards for improved care quality.

“Aetna and BHN have a collaborative relationship that is to the benefit of our members and employers,” said Chuck Lehn, BHN’s Chief Executive Officer. “These results are rewarding because they validate our model — it is possible to deliver quality care at more affordable prices.”

Aetna and BHN began their accountable care collaboration in 2011, and the tools and learning from this relationship supported BHN’s Medicare Pioneer Accountable Care Organization (ACO) model in 2012. Aetna and BHN offer the Aetna Whole Health plans — ACO-centered health plan products — to employers and individuals in the Phoenix area. The products are also available to individuals on the public exchange. In addition, Aetna care management and technologies support BHN in delivering patient-centered, accountable care to its Pioneer Medicare beneficiaries as well as Banner Health employees in seven states.

“The success of this collaboration demonstrates that insurance carriers and providers can work together in a unified approach to provide quality, coordinated care while reducing health care costs,” said Tom Dameron, Aetna’s local market president for Arizona. “We look forward to continuing our relationship with Banner to help our members live healthier, more productive lives.”

Significant results seen during the second full year of the accountable care collaboration between Aetna and BHN include improvements in cancer screening rates, including cervical and colorectal cancer screening; reductions in the percent of diabetic members with poorly controlled blood sugar levels; reductions in radiology services of approximately 9 percent; increases in generic prescribing rate by almost 4 percent; and reductions in avoidable admissions by approximately 9 percent.

Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care for all health care consumers. Nationally, more than 2.3 million members are served by value-based health care models

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